Payer & TPA Solutions

Reduce inappropriate payments and denials through upstream documentation integrity and targeted reviews.

Claims Review (Clinical)

  • Medical necessity checks
  • Utilization & coding validation
  • Evidence summaries for provider education

Denial Analytics

  • Identify high‑frequency denial drivers
  • Close‑loop feedback to providers
  • Trend dashboards and summaries

Program Support

  • Star ratings & quality measure alignment
  • Policy & documentation checklists
  • SLA‑based delivery & white‑label reports

This describes services only; PHI is handled in secure, contracted environments.